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NPI Code Detail

MEDICARE: ALYSSA MORGAN LYON

MEDICARE: ALYSSA MORGAN LYON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1932043213
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALYSSA MORGAN LYON
Provider Business Mailing Address
First Line : 750 VICTORIAN WOODS CT
Second Line :
City : MARYSVILLE
State : MI
Zip : 48040-1587
Country : US
Telephone Number : 810-294-5678
Fax Number :
Provider Business Practice Location Address
First Line : 1025 HURON AVE
Second Line :
City : PORT HURON
State : MI
Zip : 48060-3763
Country : US
Telephone Number : 810-294-5678
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/16/2026
Last Update Date : 04/16/2026

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Directions to “ ALYSSA MORGAN LYON ” Practice Location

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